How To Manage Anxiety At Night

Updated May 10, 2024by Regain Editorial Team

For most people, nighttime is a time of relaxation just before going to bed. For some, however, the nighttime is when their anxiety tends to spike, leading to undesirable symptoms and sleepless nights. If you’ve been experiencing anxiety at night that makes it difficult for you to sleep well, there are several steps you can take to get a better night’s rest. In this article, we’ll be discussing the causes and symptoms of anxiety and tips for coping with it at night.

Struggling to ease your nighttime anxiety? Therapy can help

What is anxiety?

Anxiety is a natural reaction to stressful or scary situations. Although most people have experienced anxiety at some point, not everyone struggles with it daily. People diagnosed with an anxiety disorder or another mental health condition, however, may regularly feel anxious, on edge, and concerned about something bad happening. They may be unable to control their thoughts and have trouble carrying out daily responsibilities as a result. 

Some types of anxiety disorders, like panic disorder, may cause symptoms like panic attacks, sudden and intense feelings of fear. Some people with panic disorder may experience nocturnal panic attacks, or panic attacks at night.

Symptoms of nighttime anxiety

The symptoms created by anxiety and stress can be particularly overwhelming at night and could include: 

  • Nervous feelings or anxious thoughts
  • Increased heart rate
  • A sense of danger or doom
  • Fast breathing (hyperventilation)
  • Inability to concentrate
  • Restlessness
  • Tense muscles
  • Upset stomach
  • Nocturnal panic attacks

This list of symptoms is not exhaustive, and everyone’s experience with anxiety can vary.


Causes of anxiety at night

The quality of your sleep and anxiety can go hand in hand. If you’re not getting enough sleep at night, you may be more prone to anxiety; likewise, if you’re experiencing anxiety, it may be difficult for you to fall or stay asleep. This is a paradox in itself that may seem like an inescapable one.

According to the Anxiety and Depression Association of America (ADAA), “Stress and anxiety may cause sleeping problems or make existing problems worse. And having an anxiety disorder exacerbates the problem.” This means that if you have an existing sleep disorder, anxiety could make it even worse. Common sleeping disorders include:

  • Insomnia: Difficulty falling or staying asleep, which can last short-term or long-term.
  • Sleep apnea: An experience of abnormal breathing patterns while sleeping, which can vary depending on the type of sleep apnea.
  • Restless leg syndrome: Causes uncomfortable sensations and urges to move one’s legs while trying to sleep.
  • Narcolepsy: Extreme sleepiness during the day, causing one to fall asleep suddenly and involuntarily.

Having any of these disorders could make your nighttime anxiety worse. Anxiety, in combination with any of these disorders, could even lead to nighttime panic attacks. Other possible reasons someone may experience a panic attack at night can include other health conditions, such as thyroid conditions.

Lifestyle tips that may help nighttime anxiety

While nighttime anxiety can seem overwhelming, there may be some valid treatment options to help you overcome it. In conjunction with seeking therapy, try adding these lifestyle tips recommended by the Anxiety and Depression Association of America (ADAA):


When you can’t sleep at night, you could try meditation, a practice that focuses on mindfulness. Meditation is all about allowing your thoughts to pass without judging them and being able to create a calmer state of mind for yourself. You can imagine a vast desert, a mountain top, or whatever your happy place may be. Research shows that daily meditation can enhance mood, memory, attention, and emotional control, even for those individuals who have never meditated before. Meditation has long-term effects on lowering stress levels.

Deep Breathing

Diaphragmatic breathing (also called abdominal breathing) may trigger physical responses in the body that may encourage relaxation, such as improvement in blood pressure and improvement in cortisol levels (cortisol is a hormone that increases during times of stressed).


Exercising can benefit the body physically, but it can also impact mental health. Whatever exercise you choose, whether it be anaerobic or aerobic, could have a positive effect on your overall well-being. Exercising can be an outlet for frustrations or stress, and it releases endorphins into your brain which can boost your mood. Choose the exercise that fits your lifestyle, whether it’s lifting weights, doing yoga, or going for a run.

Listening to music

Listening to music could put your mind at ease, particularly when you’re ready to go to bed. The ADAA recommends listening to calming music, which can lower your blood pressure and relax your body and mind.

To-do lists

Most people that use to-do lists say they feel both exhausted and fulfilled afterward. You could try creating a daily to-do list that helps you stay productive throughout the day so that you’re tired by the time you go to bed.

Working with a therapist to reduce feelings of anxiety

Talk therapy is an effective way to reduce feelings of stress and anxiety. One type of therapy, called cognitive behavioral therapy (CBT), is proven to help treat symptoms of anxiety and stress-related disorders. Cognitive behavioral therapy works by helping clients to identify how their interpretation of certain events and circumstances may contribute to stress and anxious feelings. Then, during cognitive behavioral therapy sessions, a therapist helps clients to reframe and adapt negative thought patterns into more productive patterns.

Struggling to ease your nighttime anxiety? Therapy can help

Lifestyle tips 

While the tips above can be helpful for coping with anxiety in the moment, the tips below may be useful for practicing good sleep hygiene and promoting higher-quality sleep and fewer symptoms of anxiety. 

Create a set sleeping schedule 

Sleeping on time can be difficult with nighttime anxiety, but it may be worth trying. Instead of staying up until you feel tired, set a time to sleep and a time to wake up, making sure you’re getting at least eight hours of rest. If you know you lie awake at night from anxiety, then try to go to sleep an hour before your set time for a head start.

Having a set sleeping schedule and not deviating from it too much could reinforce a sleep cycle for your body. This could cause you to get tired before bed, which may allow for more comfortable sleep. A set sleeping schedule allows your body to become accustomed to sleeping at a certain time, which causes it to release melatonin at that time each night. Try to avoid napping during the day, and if you must nap, limit them to no more than 30 minutes. Taking a nap during the day could make you more restless as you lie in bed because your body feels rested enough to keep going for another couple of hours.

Consider your diet

Before bed, you may feel the urge to snack or have a meal. However, eating large amounts of food could end up hindering your sleep, thus making your symptoms of anxiety worse. Overeating before bed can cause discomfort. 

With drinks, try to avoid caffeine close to bedtime. If you love drinking caffeinated beverages, then consider doing it four to six hours before bed. The amount of time caffeine takes to wear off depends on the person, so consider this when deciding when and how much to drink. Avoid alcohol before bed, as well. While it may make you feel sleepy, it could also interrupt your sleep in the middle of the night as well. Certain teas, like chamomile, can reduce anxiety. Drinking chamomile before bed can reduce stress and anxiety, and it’s also linked to treating or helping combat insomnia.

Limit your electronic use before bed

Looking at your phone or staring at your laptop before bed could be affecting your sleep more than you know. Studies show that blue light from our devices (such as phones, televisions, and laptops) can delay melatonin release. Melatonin is a hormone your body produces that makes your body less alert, making sleep more inviting. Blue light could interrupt your body’s natural sleep schedule. If you plan to adhere to a sleep schedule, try to limit your blue light consumption to increase your chances of success.

Create a restful environment

Wherever you choose to sleep, it can be important that the environment is quiet, cool, dark, and relaxing. If your room has lights shining into it through windows, then consider getting curtains to limit the light entering your room. If it feels too hot, try investing in a fan. If phone notifications keep you up all night, try switching your phone off or lowering the volume. Creating a restful environment can help you ensure you get the sleep you need.

Online counseling with Regain

If the tips above still aren’t quelling your anxiety at night, it could be time to seek help and treatment from a professional. You can speak with a therapist in your local area or pursue counseling services online through a site like Regain. Regain is a virtual counseling platform offering services for a variety of concerns. Once you sign up, you can get matched with a therapist who has experience with anxiety, insomnia, and other types of sleep disorders. This takes away the burden of having to do research to find a professional who might be right for you. Living with anxiety can be a challenge, but a therapist can help you find tools to overcome your symptoms so that you can get back to living a healthy, productive lifestyle. 

The effectiveness of online counseling 

Those struggling to sleep at night could benefit from online counseling, according to research. In one study, researchers found that an online intervention for insomnia produced statistically significant improvements in sleep quality, insomnia severity, and daytime fatigue. Participants were told to monitor their thoughts and attempt to replace anxiety-provoking thoughts with more realistic alternatives, helping to change their dysfunctional beliefs about sleep and allowing them to change those habits that led to pre-sleep cognitive arousal.


Living with anxiety can already be difficult enough, but when it interferes with your sleep, it can make it difficult to function throughout the day. Sleep can be essential to your overall health and well-being, meaning a lack of rest along with anxiety can take a toll on your body. Getting help with these issues can be crucial. A licensed therapist can work with you to identify the root of your anxiety and give you tips for getting a better night of rest. Once you’re sleeping soundly again, you can have more energy to devote to the things that matter to you in life.

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